Bexacat for Cats - Bexagliflozin - 15-mg (30 tablets) - [Diabetes]

Bexacat (bexagliflozin) Flavored Tablets are a prescription veterinary medication specifically designed for the management of diabetes mellitus in cats. Each palatable, flavored tablet contains bexagliflozin, a novel selective sodium-glucose cotransporter 2 (SGLT2) inhibitor. Bexagliflozin helps to lower blood sugar levels by preventing the kidneys from reabsorbing glucose, allowing excess glucose to be excreted in the urine. This once-daily oral medication offers a convenient way to manage feline diabetes and control blood sugar. Please note that Bexacat requires a prescription from a licensed veterinarian, who will determine the appropriate dosage based on your cat's individual needs.

Key Features of Bexacat for Cats:

• Bexagliflozin: The active ingredient, a selective SGLT2 inhibitor, effectively lowers blood sugar levels in cats with diabetes mellitus.
• Palatable Flavored Tablets: Designed with a taste that cats find appealing, making oral administration easier and improving compliance.
• Once-Daily Dosage: Simple once-a-day administration helps manage feline diabetes with convenience.
• Effective Glycemic Control: Helps regulate and control blood sugar levels in cats with diabetes mellitus.
• Veterinary Prescription Required: Ensures safe and appropriate use under the guidance of a veterinarian.
• Individualized Dosage: Your veterinarian will determine the precise dosage based on your cat's specific needs.

Indications:

Bexacat is specifically indicated to improve glycemic control in otherwise healthy cats with diabetes mellitus who have not previously been treated with insulin.

How Bexacat Works:

Bexacat contains bexagliflozin, a selective inhibitor of sodium-glucose cotransporter 2 (SGLT2). SGLT2 is a protein in the kidneys responsible for reabsorbing glucose back into the bloodstream. By blocking the action of SGLT2, Bexacat reduces the amount of glucose reabsorbed by the kidneys. This results in increased glucose excretion in the urine, leading to lower blood sugar levels in cats with diabetes mellitus.

View Bexacat Drug Facts Sheet (PDF) for more detailed information.

Bexacat for Cats: Dosage, Administration, Monitoring & Safety Information

Always provide the Client Information Sheet with the prescription.

Administer one tablet by mouth to cats weighing 6.6 lbs (3.0 kg) or greater once daily, at approximately the same time each day, with or without food, and regardless of blood glucose level.

Monitoring Your Cat on Bexacat:

Close monitoring is crucial for cats receiving Bexacat to ensure their safety and the effectiveness of the treatment.

• Immediate Discontinuation & Assessment: If your cat exhibits a sudden onset of hyporexia (reduced appetite) or anorexia (complete loss of appetite), lethargy, dehydration, or unexplained weight loss while on Bexacat, discontinue the medication immediately and seek veterinary assessment for possible diabetic ketoacidosis (DKA), regardless of their blood glucose level.
• Routine Monitoring During Treatment: Your veterinarian will regularly monitor several parameters, including:
  • Blood glucose levels
  • Fructosamine levels
  • Serum β-hydroxybutyrate (BHBA) levels (a key indicator of DKA)
  • Serum feline pancreas-specific lipase (fPL) levels (to monitor for pancreatitis)
  • Liver parameters (to assess liver health)
  • Serum cholesterol and triglyceride levels
  • Body weight
  • Clinical signs
• Pancreatitis & Hepatic Disease: Increasing or persistently elevated fPL levels or liver parameters should prompt further investigation for pancreatitis and/or liver disease, and your veterinarian may consider discontinuing Bexacat.
• Diabetic Ketoacidosis (DKA): Bexacat should be stopped if a notable reduction in BHBA is not observed after starting the medication, or if BHBA persistently rises after an initial decrease.
• Increased Cholesterol & Triglycerides: Cats with increasing or consistently high cholesterol and triglyceride levels may have a higher risk of developing DKA or euglycemic DKA.
• Poor Glycemic Control: Discontinuation of Bexacat should be considered if your cat develops poor blood sugar control, as determined by your veterinarian.
• Initial 8-Week Assessment: During the first 8 weeks of Bexacat treatment, your veterinarian will evaluate glycemic control and overall clinical improvement through:
  • Physical examination
  • An 8-hour blood glucose curve
  • Serum fructosamine levels
  • Assessment of body weight changes
• Poor Glycemic Control at 8 Weeks: If your cat shows poor glycemic control (weight loss, average blood glucose ≥ 250 mg/dL on an 8-hour curve, and/or fructosamine indicating poor control) at the 8-week mark, Bexacat should be discontinued, and insulin therapy may be considered.
• Euglycemic Diabetic Ketoacidosis: Be aware that cats can present with DKA even with normal blood glucose levels (euglycemic DKA). Prompt recognition and treatment are crucial to reduce morbidity and mortality.
• Management of DKA & Euglycemic DKA: If DKA or euglycemic DKA develops, the following steps are necessary:
  • Discontinuation of Bexacat
  • Immediate initiation of insulin therapy
  • Administration of dextrose or another carbohydrate source, regardless of blood glucose concentration
  • Prompt initiation of appropriate nutritional support to prevent or treat hepatic lipidosis (fatty liver disease).
• Urinary Tract Infections (UTIs): Cats should be screened for UTIs and treated if needed before starting Bexacat, as the medication may increase the risk of UTIs. Monitor for UTI signs during treatment and treat promptly. Discontinuation of Bexacat may be considered with recurrent UTIs.
• Increased Serum Calcium: Bexacat may increase serum calcium levels. Discontinuation is recommended in cats with persistent increases in total or ionized calcium due to the increased risk of calcium-containing uroliths (urinary stones).
• Long-Term Risk: Long-term use of Bexacat may potentially increase the risk of urothelial carcinoma (bladder cancer).
• Safe Storage: Keep Bexacat in a secure location out of reach of all animals to prevent accidental ingestion or overdose.

Contraindications:

• Do not use Bexacat in cats with diabetes mellitus previously treated with insulin, currently receiving insulin, or with insulin-dependent diabetes mellitus. This combination or switch increases the risk of DKA or euglycemic DKA and death.
• Do not use Bexacat in cats with evidence of liver disease or reduced kidney function due to the risk of severe adverse reactions.

Warnings:

User Safety Warnings:

Not for human use. Keep out of reach of children. If accidentally ingested, contact a physician immediately.

Animal Safety Warnings:

• Do not initiate Bexacat in cats with:
  • Anorexia, dehydration, or lethargy at diabetes diagnosis.
  • fPL levels > 5.3 mcg/L, imaging consistent with pancreatitis, or a history/current signs of pancreatitis.
  • Laboratory values consistent with DKA (elevated ketones, metabolic acidosis).
  • BHBA > 37 mg/dL, or BHBA > 25 mg/dL with a history of renal disease or metabolic acidosis.
• Persistent high bexagliflozin levels due to liver/kidney issues can lead to prolonged glucosuria/euglycemia after stopping Bexacat, potentially causing dehydration and requiring hospitalization for complications like DKA or hepatic lipidosis.
• Screen for and treat UTIs before starting Bexacat. Monitor for UTIs during treatment and consider discontinuing Bexacat with recurrent UTIs.
• Discontinue Bexacat in cats with persistent increases in serum calcium due to the increased risk of urinary stones.
• Long-term use may increase the risk of urothelial carcinoma.
• Store securely out of reach of all animals.

Precautions:

• Discontinue Bexacat in cats with diarrhea unresponsive to conventional therapy.
• Consider temporary discontinuation during decreased caloric intake (surgery, poor appetite) to reduce DKA/hepatic lipidosis risk.
• Bexacat's diuretic effect may cause inappropriate urination in some cats.
• Increased appetite (polyphagia) may persist despite good blood sugar control and can lead to weight gain.
• Approximately 20-30% of cats may have persistent increased thirst/urination, increasing dehydration-associated DKA risk.
• Safety in breeding, pregnant, and lactating cats has not been evaluated.

Storage:

Store Bexacat at room temperature 68 to 77 ? (20 to 25 ?).